No abstract

Resumo -O objetivo deste trabalho foi utilizar a classificação orientada a objetos em imagens TM/ Landsat-5, para caracterizar classes de uso e cobertura da terra, na região do Médio Araguaia. A cena 223/068, adquirida em 5/9/2010, foi submetida a correção radiométrica, atmosférica e geométrica, como etapas de pré-processamento. Em seguida, foram geradas duas imagens por meio das matemáticas de bandas espectrais do índice de vegetação por diferença normalizada (NDVI) e do índice de água por diferença normalizada modificado (MNDWI), utilizados na classificação de imagens. Para a segmentação destas, utilizaram-se os parâmetros de escala 250, 200, 150, 100, 50, os algoritmos "assign class" e "nearest neighbor", e os descritores de média, área e relação de borda. Foi empregada matriz de confusão, para avaliar a acurácia da classificação, por meio do coeficiente de exatidão global e do índice de concordância Kappa. A exatidão global para o mapeamento foi de 83,3%, com coeficiente Kappa de 0,72. A classificação foi feita quanto às fitofisionomias do Cerrado, ao uso antrópico e urbano da terra, a corpos d'água e a bancos de areia. As matemáticas de bandas espectrais utilizadas apresentam resultados promissores no delineamento das classes de cobertura da terra no Araguaia.Termos para indexação: classificação digital de imagens, fitofisionomias do Cerrado, MNDWI, NDVI, segmentação de imagens, sensoriamento remoto. Object-oriented classification applied to the characterization of soil use and land cover in the Araguaia, BrazilAbstract -The objective of this work was to use object-oriented classification in TM/Landsat-5 images to characterize land use and land cover classes in the Araguaia region. The scene 223/068, acquired on 9/5/2010, was subjected to the following pre-processing stages: radiometric, atmospheric, and geometric corrections. Two images were generated by the mathematical spectral bands normalized difference vegetation index (NDVI) and modified normalized difference water index (MNDWI), which were used in the classification process. For image segmentation, the scale parameters 250, 200, 150, 100, 50, the algorithms assign class and nearest neighbor, and the attributes of average, area, and border ratio were used. A confusion matrix was used to assess the accuracy of the classification, using the overall accuracy coefficient and the Kappa index of agreement. Overall accuracy for mapping was 83.3%, with Kappa coefficient of 0.72. The classification was done as to Cerrado physiognomies, anthropic and urban use of the land, water bodies, and sand banks. The mathematical spectral bands used are promising for delineating classes of the land cover in Araguaia.

BackgroundGoodpasture’s syndrome, a rare disease, is an organ-specific autoimmune disease mediated by anti-glomerular basement membrane antibodies. Its pathology is characterized by crescentic glomerulonephritis with linear immunofluorescent staining for immunoglobulin G on the glomerular basement membrane. Although rare, a few cases with absence of circulating anti-glomerular membrane antibodies have been described.Case presentationThe objective of this clinical case report is to describe and discuss a case of a 27-year-old white man who was hospitalized with a 1-year history of weight loss and a 1-month history of hemoptysis, with aggravation  the day before, having developed dyspnea and cough in the previous 24 hours. An analytical study showed normocytic normochromic anemia with a hemoglobin level of 7.2 g/dL and leukocytosis with normal renal function and coagulation times. A blood transfusion was performed without complications. Chest computed tomography revealed a reticulonodular infiltrate of both lungs. Bronchoscopy showed no apparent lesions. Sputum cultures, rapid urine antigens for Legionella pneumophila and Streptococcus pneumoniae, studies for Influenza, virologic markers and serologic studies for autoimmunity were all negative. At the end of the tenth day his general state deteriorated with fatigue, hematuria, and in 3 days he developed aggravation of renal function with recurrent hemoptysis and anemia. Immunosuppression with daily prednisolone 1 g administered intravenously was initiated. An urgent bronchoscopy showed no lesions. A kidney biopsy showed fibrinoid necrosis and cellular crescents. Immunofluorescence revealed a linear immunoglobulin G deposition compatible with Goodpasture’s syndrome. Immunosuppressive therapy with daily cyclophosphamide 120 mg orally was added. Subsequently he was transferred to a referral center at which 21 sessions of plasmapheresis and four sessions of hemodialysis were performed with good response; he currently has no need of hemodialysis.ConclusionsThe absence of circulating anti-glomerular basement membrane antibodies in Goodpasture’s syndrome adds complexity to the diagnosis creating an unusual setting in a rare disease. In our case a kidney biopsy was essential for diagnosis and clinical approach. Studies have shown that early aggressive therapy leads to an improved prognosis. Physicians should consider tissue diagnoses such as bronchoscopy and kidney biopsy in pulmonary renal syndrome.

1995-May 2015. Patients with melanoma, sarcoma, lymphoma, and adenoid cystic carcinoma were excluded. Disease extent, stage, treatments, and margin status were recorded. Between-group differences in disease-free survival (DFS), overall survival (OS), and freedom from local progression (FFLP) were evaluated using Kaplan-Meier estimation and log-rank test. Multivariate analysis was performed using Cox Proportional Hazards models. Results: A total of 103 patients were treated for cancers of the nasal cavity (68) and maxillary (22), ethmoid (8), sphenoid (4), and frontal (1) sinuses. Eighty had surgery AE adjuvant therapy. Of 18 patients treated non-operatively, 7 completed induction chemotherapy and (chemo)radiation, one had chemotherapy, and 10 had (chemo)radiation. Fifty-four patients had squamous cell carcinoma (SCC), 33 esthesioneuroblastoma (ENB), 6 sinonasal undifferentiated carcinoma (SNUC), 5 sinonasal neuroendocrine carcinoma (SNEC), and 5 adenocarcinoma or adenosquamous carcinoma. Sixty-six percent (39/59) of patients with SCC or adenocarcinoma had T4 disease. Intracranial extension was identified in 47% (47/103) patients. Surgical margins were positive in 55% (44/80) of resections, but gross total resections (GTR) were achieved in 86% (73/85). At a median follow-up of 5.6 years (0.1-17 years), 33 patients recurred and 34 expired. We observed 19 local, 6 regional, and 18 distant recurrences. At 3 years, DFS, OS, and FFLP were 58%, 69% and 62% in the entire cohort, respectively. Among resected patients, positive margins were associated with worse 3-year DFS (47% vs 79%, P<.001), OS (56% vs 91%, PZ.005), and FFLP (50% vs 82%, PZ.004). In non-operated patients, 3-year DFS, OS and FFLP were very similar: 47%, 56%, and 53%, respectively. For patients with SCC, those treated non-operatively had similar DFS (HR 0.94, PZ.9), OS (HR 1.1, PZ.8), and FFLP (HR 1.2, PZ.78) to those with positive margins. All ENBs were resected and, compared to SCC, were associated with better DFS (PZ.06), OS (PZ.01), and FFLP (PZ.02). In the surgical group, there were 4 intracranial infections and 1 stroke. In the non-operative group, 1 patient died from stroke during induction therapy. Conclusion: Excellent outcomes were achieved after complete resections with negative margins. For patients with SCC, upfront necessity for nonoperative treatment yields outcomes similar to surgery with inability to clear margins, which is not remediated by adjuvant therapy.